Amniotic fluid gel acetylcholinesterase determination in prenatal diagnosis: dark field illumination as a method for improving the detection of precipitation bands.

This paper describes a sensitive method for the detection of precipitation bands in the qualitative acetylcholinesterase (AChe) gel test. This method--dark field illumination--is compared with two existing methods of detection: epi-illumination of unstained gels and transillumination of dithio-oxamide stained gels. The comparison has been carried out on a selected series of 271 amniotic fluid samples, taken before the 22nd week of gestation. All 96 samples from normal pregnancies were scored as negative with all three visualization methods. For the detection of neural tube defects (NTD) and omphaloceles, dark field illumination proved to be more efficient than epi-illumination or dithio-oxamide staining. In case of another congenital defect, we obtained a positive result with dark field illumination, and a negative one with the other detection methods. It is concluded that dark field illumination was shown to be the most sensitive method for the detection of precipitation bands.